The report identifies four false performance improvement assumptions characteristic of command & control thinking that have diminished health care system performance in Alberta specifically, and in Canadian health care and public administration generally;
centralization increases coordination and control,
consolidation takes advantage of economies of scale reducing costs,
increasing utilization improves system efficiency, and
performance targets drive improvement.
The report argues that recent efforts at addressing system issues won't work because these solutions are products of the same command & control thinking that created the issues.--today's problems cannot be solved by yesterday's thinking.
Command & control thinking is contrasted with the Systems Thinking of Edwards Deming and The Decline of Health Services in Alberta details how this change in perspective and management style can improve Canadian health care system performance.
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The Quality Council of Alberta is a membership-based organization dedicated to the application of Quality, Deming's System's Thinking and Evidence & Knowledge-Based Management.